Dangers Of Outside Food

August 17, 2021

Foodborne viruses have long been recognised as a growing concern to the food industry and can potentially become a serious public health issue. The Hepatitis A virus is responsible for most food-related outbreaks worldwide. Foods with high risks of contamination of Hepatitis A include shellfish, oysters, and fresh produce such as salads, fruit and vegetables.

Transmitted through faeces

Restaurant food remains a common source of Hepatitis A as the virus often finds its way into restaurants through the people who work in these restaurants who themselves are infected with the virus. Hepatitis A is transmitted via faecal-oral transmission. This means that the virus is transmitted via food or water that has been contaminated by an infected person who probably handled the food/water without washing their hands after going to the bathroom. What is particularly troubling is the fact that infected individuals can transmit the virus up to two weeks before they themselves exhibit any symptoms, meaning that they often transmit the virus before they are even aware that they are infected.

Chefs, cooks, kitchen staff and other employees in a restaurant that handle food and beverage, can easily pass the virus through food, drinks, dishes, glasses, and utensils that are used by patrons of the restaurant. Strict hand hygiene such as thorough handwashing after using the bathroom and wearing gloves when handling food are key factors in preventing the spread of these viruses. It is also important for diners at a restaurant to practise good hygiene too to protect themselves from becoming ill. Steps such as washing their own hands before eating and after visits to the restroom are good habits to have.

The average time from exposure to onset of symptoms is about 28 days with a relative range of 15 to 50 days. Hepatitis A begins with symptoms of fever, reduced appetite with poor oral intake, nausea, vomiting, diarrhoea, and generalised malaise. At onset or within a few days following initial symptoms, an individual may note jaundice which is yellowish discoloration of the eyes and skin. Additionally, they may find they have dark-coloured urine or light-coloured stools. They may also experience abdominal pain and tenderness. Examination by a doctor may reveal that their liver and/or spleen are enlarged.


Once infected, no reinfections

There is no specific treatment for Hepatitis A. All measures of managing this infection are purely supportive. Hepatitis A infection is self-limiting as it may last for several weeks with relapsing symptoms. However, full recovery is expected although symptoms may persist on and off for a few weeks before the patient fully recovers.

Individuals who work at restaurants, grocery stores and supermarkets who have been diagnosed with Hepatitis A should be excluded from work for at least two weeks after their onset of symptoms. If they had experienced jaundice, they should not return to work for at least one week after the onset of jaundice. Once an individual has recovered from Hepatitis A, they cannot be reinfected. They are immune for life and do not continue to carry the virus.

Course of action

According to the World Health Organization, the most effective way to prevent Hepatitis A infection is to improve sanitation, practise proper handwashing techniques and ensure clean and hygienic handling of food. Avoid sharing food, cutlery and drinks with other people. Avoid eating raw or undercooked shellfish. When travelling, particularly in places with poor sanitation, drink bottled water and avoid food that might have been prepared using contaminated water.

Hepatitis A immunoglobulin is a drug that contains antibodies against the Hepatitis A virus. This drug can be taken within two weeks of exposure to the virus. It is around 85 percent effective but its effects are temporary and may last up to only three months. Hepatitis A vaccination is still the preferred choice for prevention. Vaccines against Hepatitis A are available as inactivated single antigen vaccines or in combination with the Hepatitis B vaccine. Hepatitis A vaccines do not cause any severe reactions, and the benefits of vaccinating yourself and your family outweigh any risks. The best thing to do is to consult a physician on your options for vaccination.

Dr. Harpreet Kaur A/P Harnam Singh
Consultant Internal Medicine Physician
Columbia Asia Hospital – Tebrau

MBBS (IMU), MRCP (UK), AM (Malaysia)

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  This article first appeared in New Straits Times, 22 July 2021
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